The Credentialing Specialist is responsible for submitting and maintaining payor network initial and re-enrollment credentialing submissions for new or continued ancillary in-network status.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
- Demonstrate a consistently positive, cooperative, self-motivated, courteous and professional approach in performing all assigned tasks
- Work with insurance payors submitting credentialing documents for in-network participation status
- Work with insurance payors submitting timely re-enrollment credentialing documents for continued in-network participation status
- Ensures and maintains overall accuracy of credentialing database
- Set-up and maintain insurance payors’ web portals
- Assist with training new hires when needed
- Assume other duties within scope of training as assigned by the Director, Payor Relations or Executive Management
QUALIFICATIONS (EDUCATION, EXPERIENCE, SKILLS)
- High school diploma or GED
- 1-2 years related managed care/healthcare experience
- Proficient computer/data entry skills, intermediate proficiency in Microsoft Excel.
- Effective interpersonal and communication skills